Now that the organization of the San Joaquin Valley CCOP has been accomplished, the second year will focus on strengthening and expanding the program. The areas to strengthen will include increasing patient accrual, improving protocol adherence, and increasing education activities for physicians and the public about the CCOP. At the same time, the San Joaquin Valley CCOP will extend its catchment area to include the oncologists of Bakersfield (Kern County), making clinical trials available to more San Joaquin Valley cancer patients. The possibility of establishing a community IRB will be considered. Opportunities for soliciting community support for the San Joaquin Valley CCOP will also be investigated. To increase accrual, the CCOP will determine the percentage of eligible patients entered by each physician, based on the patient log. A meeting will be held with each physician who has entered less than 10% of his eligible patients, to discuss the situation and clarify any concerns. A group meeting will be held to decide on guidelines regarding physician participation. Ways to improve protocol adherence will include developing reminders to physicians of protocol requirements. A Karnofsky scale will be placed in each patient's chart. The chart will be clearly identified as a protocol patient chart, using a bright sticker. A summary schedule of tests and visits required by protocol will be developed. Patients will be enlisted by providing them with a calendar of key events in their treatment course. It will be important to the CCOP program nationally to increase publicity efforts. Locally, the San Joaquin Valley CCOP will continue to address groups of physicians and health care officials. Opportunities to speak to community groups will be sought. The ability of the CCOP program to increase physician and patient participation will be enhanced by an informed community.